Hafizi Leili, Khoshniat Freshteh, Mirteimouri Masoumeh, Khazaeian Safoura
Supporting the Family and the Youth of Population Research Core, Department of Obstetrics and Gynecology Faculty of Medicine, Mashhad University of Medical Sciences Mashhad Iran.
Supporting the Family and the Youth of Population Research Core Hazrat Abolfazl Hospital, Mashhad University of Medical Sciences Kashmar Iran.
Health Sci Rep. 2025 Feb 16;8(2):e70472. doi: 10.1002/hsr2.70472. eCollection 2025 Feb.
Although some women who undergo cesarean section need to receive prophylactic Enoxaparin due to the increased risk of thromboembolism during their puerperium period, the question is always raised of whether this drug with the mechanism of increased bleeding may increase surgical wound complications. Hence, the present study was conducted with the aim of a comparative study on complications of abdominal incision in cesarean section patients with and without receiving Enoxaparin.
A quasi-experimental study was conducted on 789 cesarean section participants (317 receiving Enoxaparin and 472 control subjects), 20-40 years pregnant women in Imam Reza and Ummal-Banin hospitals in Mashhad, Iran. All participants who scored three or more for thromboembolism risk based on the National Protocol received Enoxaparin after surgery. Those with underlying wound complication risk factors were excluded from the study. Then, both groups were evaluated for abdominal incision complications up to 2 weeks after their delivery and were compared with each other. A value < 0.05 was considered significant.
In total, 5% of patients in the Enoxaparin group and 5.5% in the control group had ulcer complications ( = 0.7). The frequency of the type of complication between the two groups was as follows: hematoma ( = 0.8), ecchymosis ( = 0.5), wound infection ( = 0.9), wound partial dehiscence ( = 0.09), wound total dehiscence ( = 0.3), secondary closure of the incision ( = 0.7) which had no meaningful statistical difference.
Based on the outcomes obtained in the present study, prescribing Enoxaparin after a cesarean in cases receiving this drug for thromboembolic prophylaxis did not significantly increase the complications of abdominal incision, and there was no need for more incision care.
尽管一些接受剖宫产的女性因产褥期血栓栓塞风险增加而需要接受预防性依诺肝素治疗，但总会有人质疑这种具有增加出血机制的药物是否会增加手术伤口并发症。因此，本研究旨在对接受和未接受依诺肝素的剖宫产患者腹部切口并发症进行比较研究。
在伊朗马什哈德的伊玛目·礼萨医院和乌玛勒·巴宁医院对789名剖宫产参与者（317名接受依诺肝素治疗者和472名对照者）进行了一项准实验研究，参与者为年龄在20至40岁的孕妇。所有根据国家方案血栓栓塞风险评分为3分或更高的参与者在术后接受依诺肝素治疗。有潜在伤口并发症危险因素的患者被排除在研究之外。然后，对两组患者在分娩后2周内的腹部切口并发症进行评估，并相互比较。P值<0.05被认为具有统计学意义。
依诺肝素组5%的患者和对照组5.5%的患者出现溃疡并发症（P=0.7）。两组之间并发症类型的发生率如下：血肿（P=0.8）、瘀斑（P=0.5）、伤口感染（P=0.9）、伤口部分裂开（P=0.09）、伤口完全裂开（P=0.3）、切口二期缝合（P=0.7），均无显著统计学差异。
根据本研究获得的结果，对于因血栓栓塞预防而接受该药物治疗的剖宫产患者，术后使用依诺肝素并不会显著增加腹部切口并发症，无需加强切口护理。
